ACA Exchanges: Here is a Basic Resource Guide

[Zorra]

that I created and am using to help folks sign up for the Health Insurance Marketplace exchanges.

Please feel free to use it to help yourself or others sign up.


Affordable Care Act Basic Resource Guide

This is a compilation of links to websites that I have gathered, designed to give you fast, easy access to basic resources providing information that you may find helpful for understanding your health insurance options in the new Health Insurance Marketplace Exchanges.

Please keep in mind, because this is a new program, it may change as they work the bugs out.

Marketplace open enrollment is a 6 month period, from October 1 to March 31.

Health Insurance Marketplace: You can create your Marketplace Account beginning on Oct. 1.

https://www.healthcare.gov/

https://www.healthcare.gov/quick-answers/#step-1

https://www.healthcare.gov/creating-an-account-and-logging-in/

Kaiser Foundation Subsidy Calculator. There is important information for you at this link, and you can get an estimate of the insurance subsidy you may be eligible for here:

http://kff.org/interactive/subsidy-calculator/

There are four types of plans:

• Bronze: Your plan pays 60%. You pay 40%.
• Silver: Your plan pays 70%. You pay 30%.
• Gold: Your plan pays 80%. You pay 20%
• Platinum: Your plan pays 90%. You pay 10%.

How to find the Health Insurance Plan that is right for you:

https://www.healthcare.gov/blog/how-to-find-the-health-insurance-plan-that-s-right-for-you/

Prices will be available for Marketplace Insurance Plans on Oct. 1:

https://www.healthcare.gov/how-much-will-marketplace-insurance-cost/

10 Essential Benefits you receive from the Affordable Care Act – What is covered under Marketplace Insurance Plans:

1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management, and
10. Pediatric services, including oral and vision care

http://www.healthinsurance.org/learn/health-reforms-10-essential-benefits/

The ACA and Women:

http://www.hhs.gov/healthcare/facts/factsheets/2012/03/women03202012a.html

Premium Tax Credit

https://www.healthcare.gov/glossary/premium-tax-credit/

Qualifications For Lower Premiums:

https://www.healthcare.gov/will-i-qualify-to-save-on-monthly-premiums/

Some FAQ

http://kff.org/health-reform/faq/health-reform-frequently-asked-questions/

Medicaid Eligibility

http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.html

Who is required to obtain insurance under the ACA:
http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision

The main ACA IRS homepage is:
http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home

What is the Affordable Care Act?

The Patient Protection and Affordable Care Act (PPACA),[1] commonly called Obamacare[2][3] or the Affordable Care Act (ACA), is a United States federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act, it represents the most significant regulatory overhaul of the country's healthcare system since the passage of Medicare and Medicaid in 1965.[4]
The ACA aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government. It provides a number of mechanisms—including mandates, subsidies, and insurance exchanges—to increase coverage and affordability.[5][6] The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex.[7][8] Additional reforms aim to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity through increased competition, regulation, and incentives to streamline the delivery of health care. The Congressional Budget Office projected that the ACA will lower both future deficits[9] and Medicare spending.[10]
http://en.wikipedia.org/wiki/Affordable_Care_Act

Full Text of the Affordable Care Act (this is a pdf file):

http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf

[BlueStreak]

1. I seem to fall into a Catch-22

We are retired, but not 65 yet. We have savings, but our taxable income is pretty near zero. Because of this, I'm almost positive that the exchange will direct us to Medicaid. But in Indiana, they have a f###ed up Medicaid system, and the Obama administration is negotiating with them to let them keep that system and still get the Fed money. Only 45,000 people in the entire state can receive Medicaid assistance, and it is asset-tested -- which is supposed to not be allowed if you participate in the Medicaid expansion. Basically the Obama administration is giving everything away here, negotiating away the Medicaid principles.

So I get nothing. I can't participate in the exchanges. I can't participate in Medicaid. I can't get any of the incentive payments to help buy the coverage because that is all tied in with the exchanges. I am on my own to buy my own policy, which will cost me twice what it would be in the exchange, I bet.

I hope I am missing something, but I don't think so. Sucks for me.

[Zorra]

2. So sorry; I've been doing a lot of research, and conservative states are just flat out cruel to

many of their citizens with regard to health care.

I hope the feds do something to fix this for you.

[BlueStreak]

4. We wil manage OK, but there will be many more in my catch-22 that will really struggle with this.

My big concern is that if I am not in the exchange, the insurance companies could really stick it to me (as if they aren't already).

[HereSince1628]

5. Wisconsin is working to unload medicaid responsibilities, also.

Medicaid isn't going to be the catch-all safety net.

[BlueStreak]

6. It is really sickening to hear Beltway blowhards bellowing oblivious to the facts

Indiana has a population of 6.5 million. Indiana's Medicaid program is limited to 45,000 recipients. That is SEVEN-TENTHS OF ONE FREAKING PERCENT. To serve such a tiny fraction of the population, the state does asset testing. Basically you can only get Medicaid if you have absolutely zero income and absolutely zero assets. Three are some slight exceptions to this, but for practical purposes, you have to be completely broke.

And if the program only serves 0.7%, of course it should help those at the very bottom first. I don't argue with that.

What I do argue with is:

1) the Governor negotiating with the state to get some of that Obamacare money without actually changing the fundamental principles behind the program. It will still serve under 1% of the population and will still be means-tested, such that it goes nowhere near servicing the population below the poverty level. Indiana has about 14% below poverty level. And the Obama administration is negotiating with Indiana to do exactly that -- allow them to keep their POS Medicaid "solution" that doesn't do anything to fill the gap as intended by Obamacare, while still letting Indiana have all that Medicaid expansion money.

2) Beltway politicians talking about this as if they have solved some problems. They don't seem to know or care what is really going on out here.

What really pisses me off is that this was all so necessary. I'm not looking for a handout. I can afford to pay fair value for insurance. All I ask is that the policies be required to provide real health care and that I not have to pay far more than the policy actual costs the providers. We have a program that works. It is called Medicare. All they needed to so was simply to allow those under 65 to BUY insurance from the Medicare system at the actual cost. But this President unilaterally took that option off the table before the very first discussion ever started.

[cbayer]

3. Wow, Zorra! I wish I could recommend this more than once.

I am about to sign up for something in California and have been procrastinating badly.

You have done a tremendous job here and I promise you I will personally be using this as a reference as I go through the process.

[Zorra]

7. Thanks, and I hope it serves you well.

[Mojorabbit]

8. Great post! nt